Background

Ralstonia pickettii is an opportunistic waterborne microbe which can survive in many kinds of solutions. Contamination of these solutions may result as outbreaks, which can be mortal for immuncompromised patients. Herein we report an outbreak of R. pickettii related to contaminated saline infusion in our center.

Methods

This study was conducted in Ankara Pediatric City Hospital. An outbreak occured in Pediatric Hematology and Oncology Unit between August 28, 2019 and September 13, 2019. When the outbreak occured, infection control team began an investigation. Environmental samples were collected in order to find the source of the outbreak.

Results

A total of 11 patients with catheter related blood stream infection caused by R. pickettii who were diagnosed with leukemia were affected. None of the patients infected with R. pickettii died during the outbreak. A total of seventy environmental samples were cultured with the purpose of finding the source of outbreak. R. pickettii grew in normal saline solution culture and all isolates had the same clone of R. pickettii. The outbreak lasted two weeks and was controlled by stopping the usage and sending back the saline solutions belonging to the same manufacturing batch.

Conclusions

We reported an outbreak of R. pickettii BSIs in highly immunocompromised patients due to contaminated intravascular solution, which was rapidly controlled by infection control measures. Vigilant surveillance by hospital infection control teams and prompt investigation to identify the source of nosocomial infections are crucial to stop an outbreak.

中文翻译：

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小儿白血病患者中的一次 Ralstonia Pickettii 血流感染暴发

背景

Ralstonia pickettii是一种机会性水生微生物，可以在多种溶液中存活。这些溶液的污染可能导致爆发，这对于免疫功能低下的患者可能是致命的。在此，我们报告了与我们中心的受污染盐水输注有关的R. pickettii暴发。

方法

这项研究是在安卡拉儿科城市医院进行的。2019 年 8 月 28 日至 2019 年 9 月 13 日，儿科血液肿瘤科发生暴发疫情。疫情发生时，感染控制小组展开调查。收集环境样本以寻找爆发的源头。

结果

共有11名被诊断为白血病的由R. pickettii引起的导管相关血流感染患者受到影响。感染R. pickettii的患者在爆发期间均未死亡。共培养了70个环境样本，目的是寻找暴发源。R. pickettii在生理盐水培养中生长，所有分离株均具有相同的R. pickettii克隆。疫情持续了两周，通过停止使用并将属于同一生产批次的盐溶液送回来控制。

结论

我们报告了由于受污染的血管内溶液而在高度免疫功能低下的患者中爆发的R. pickettii BSI ，感染控制措施迅速控制了这种情况。医院感染控制小组的警惕监测和迅速调查以确定医院感染的来源对于阻止疫情爆发至关重要。